Yamagishi Yuko, Kusunoki Susumu
Department of Neurology, Kindai University, Faculty of Medicine.
Rinsho Shinkeigaku. 2020 Apr 24;60(4):247-252. doi: 10.5692/clinicalneurol.cn-001398. Epub 2020 Mar 31.
Guillain-Barré Syndrome (GBS) is an acute monophasic immune-mediated neuropathy, generally considered to be of good prognosis. However, 15-20% of GBS patients cannot walk independently at six months from onset. Poor prognostic factors for long-term functional disability included old age, preceding diarrhea, muscle weakness on admission and on day 7 from admission, severe GBS disability score at two weeks from admission and IgG antibody against GD1a/GD1b ganglioside complex. Factors related with requirement of mechanical ventilation included the time from onset to admission <7 days, muscle weakness on admission, facial and/or bulbar weakness and IgG antibody against GQ1b. Recently modified Erasmus GBS outcome score (mEGOS) and Erasmus GBS respiratory insufficiency score (EGRIS) were reported as prognostic factors for the long-term functional disability and respiratory insufficiency. Those were designed on Dutch patients. The usefulness of these tools in Japan or other countries remained unknown. The authors validated mEGOS and EGRIS on Japanese GBS patients in Japanese GBS outcome study, which revealed that these tools were also adaptable on Japanese GBS patients. To identify clinical and biological factors of GBS in more detail, such a large scale prospective study as International GBS outcome study (IGOS) is warranted.
吉兰-巴雷综合征（GBS）是一种急性单相免疫介导性神经病，一般认为预后良好。然而，15%至20%的GBS患者在发病后六个月仍无法独立行走。长期功能残疾的不良预后因素包括老年、前驱腹泻、入院时及入院后第7天的肌肉无力、入院后两周时严重的GBS残疾评分以及抗GD1a/GD1b神经节苷脂复合物的IgG抗体。与需要机械通气相关的因素包括发病至入院时间<7天、入院时肌肉无力、面部和/或延髓肌无力以及抗GQ1b的IgG抗体。最近报道的改良伊拉斯谟GBS结局评分（mEGOS）和伊拉斯谟GBS呼吸功能不全评分（EGRIS）是长期功能残疾和呼吸功能不全的预后因素。这些评分是基于荷兰患者设计的。这些工具在日本或其他国家的实用性尚不清楚。作者在日本GBS结局研究中对日本GBS患者验证了mEGOS和EGRIS，结果显示这些工具也适用于日本GBS患者。为了更详细地确定GBS的临床和生物学因素，开展像国际GBS结局研究（IGOS）这样的大规模前瞻性研究是很有必要的。
